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Pain, Anxiety and Analgesics: A Comparative Study of Elderly and Younger Surgical Patients

Published online by Cambridge University Press:  29 November 2010

Kathleen Oberle
Affiliation:
University of Alberta Hospitals
Pauline Paul
Affiliation:
Faculty of Nursing, University of Alberta
Judy Wry
Affiliation:
University of Alberta Hospitals
Michael Grace
Affiliation:
Faculty of Medicine, University of Alberta

Abstract

To determine if the post-operative experience of elderly and younger patients is different, data were collected from 41 elderly patients (65 years and older) and 249 younger patients (under 65 years). Pain and anxiety were assessed on days two and three post-operative. Anxiety was also measured pre-operatively. Amount of analgesic ordered and given, and time of last analgesic prior to pain assessment were recorded. Significant differences were found in the number of analgesics given, with the elderly receiving fewer analgesics. There were no significant differences in pain intensity levels. In both age categories patients were given less analgesic on the third post-operative day, regardless of pain intensity. The two groups chose almost, identical pain descriptors. In both groups strong associations were observed between post-operative anxiety and pain, but pre-operative anxiety seemed unrelated to post-operative pain levels. It was concluded that health care professionals manage pain similarly for both younger and elderly patients, but the elderly require less analgesic for pain control.

Résumé

Afin de déterminer si l'expérience postopératoire diffère entre les patients âgés et les patients plus jeunes, 41 patients âgés (65 ans et plus) et 249 patients plus jeunes (moins de 65 ans) participèrent à cette étude. La douleur et l'anxiété furent mesurées les deuxième et troisième jours postopératoires. L'anxiété fut aussi mesurée avant la chirurgie. Le nombre d'analgésiques presents et donnés, ainsi que le délai entre l'administration du dernier analgésique et l'evaluation de la douleur furent notés. Tandis que l'intensité de la douleur ne variait pas significativement, le nombre d'analgésiques donnés était significativement différent, les personnes âgées en recevant moins. Les patients des deux groupes reçurent moins d'analgésiques le troisième jour postopératoire, indépendamment de l'intensité de la douleur. Les sujets des deux groupes choisirent les descripteurs de douleur de façon presque identique. De fortes associations furent observées entre l'anxiété postopératoire et la douleur, alors que l'anxiété préopératoire et la douleur, ne semblèrent pas reliées. II fut conclu que les professionels de la santé traitent la douleur des personnes âgées et plus jeunes de façon similaire, et que les personnes âgées requièrent moins d'analgésiques.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1990

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References

Bellville, J.W., Forrest, W.H., Miller, E., & Brown, B.W. (1971). Influence of age on pain relief for analgesics. A study of post-operative patients. JAMA, 217, 18351840Google Scholar
Brown, J.S., Buchanan, D., & Hsu, L. (1978). Differences in sick role behavior during hospitalization after open heart surgery. Research in Nursing and Health, 1, 3748Google Scholar
Clark, W.C., & Mehl, L. (1971). Thermal pain: A sensory decision theory analysis of the effect of age and sex on d', various response criteria and 50% pain threshold Journal of Abnormal Psychology, 78, 202212CrossRefGoogle Scholar
Cohen, F.L. (1980). Postsurgical pain relief: Patients’ status and nurses’ medication choices. Pain, 9, 265274Google Scholar
Collins, L.G., & Stone, L.A. (1966). Pain sensitivity, age and activity level in chronic schizophrenics and normals. British Journal of Psychiatry, 112, 3335CrossRefGoogle Scholar
Dudley, S.R., & Holm, K. (1984). Assessment of the pain experience in relation to selected nurse characteristics. Pain, 18, 179186CrossRefGoogle ScholarPubMed
Faherty, B.S., & Grier, M.R. (1984). Analgesic medication for elderly people postsurgery Nursing Research, 33, 369372Google Scholar
Grossman, S.A., & Sheidler, V.R. (1987). An aid to prescribing narcotics for the relief of cancer pain. World Health Forum, 8, 525529Google Scholar
Hargreaves, A. (1987). Implementing TENS to control post-operative pain. Unpublished master's thesis, University of Alberta, EdmontonGoogle Scholar
Harkins, S.W., & Chapman, R.C. (1977). The perception of induced dental pain in young and elderly women. Journal of Gerontology, 32, 428435CrossRefGoogle Scholar
Jeans, M.E., Mackenzie, F., & Taylor, H. (1983). Hospital stress: A comparison between long and short-stay patients. In Karvitz, M. & Lauria, J. (Eds.), Nursing research: A base for practice (pp. 391401). Proceedings of the 9th National Conference, McGill University School of Nursing, Montreal, QuebecGoogle Scholar
Johnson, J.E., Rice, V.H., Fuller, S., & Endress, M.P. (1978). Sensory information, instruction in coping strategy and recovery from surgery. Research in Nursing and Health, 1, 417Google Scholar
Marks, R.M., & Sachar, E.G. (1973). Undertreatment of medical inpatients with narcotic analgesics. Annals of Internal Medicine, 78, 173181Google Scholar
Martinez-Urrutia, A. (1975). Anxiety and pain in surgical patients. Journal of Consulting and Clinical Psychology, 43, 437442Google Scholar
Melzack, R. (1975). The McGill pain questionnaire: Major properties and scoring methods. Pain, 1, 277299Google Scholar
Nayman, J. (1979). Measurement and control of postoperative pain. Annals of the Royal College of Surgeons of England, 61, 419426Google Scholar
Reading, A.E. (1983). The McGill Pain Questionnaire: An appraisal. In Melzack, R. (Ed.), Pain measurement and assessment, (pp. 5561). New York, NY: RavenGoogle Scholar
Scott, L.C., Clum, E.A., & Peoples, J.B. (1983). Pre-operative predictors of postoperative pain. Pain, 15, 283293CrossRefGoogle Scholar
Spielberger, C.D., (1980). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists. Palo Alto, CAGoogle Scholar
Sriwatanakul, K., Weis, O.F., Alloza, J.L., Kelvie, W., Weintraub, M., & Lasagna, L. (1983). Analysis of narcotic analgesic usage in the treatment of post-operative pain. JAMA, 250, 926929CrossRefGoogle Scholar
Taenzer, P., Melzack, R., & Jeans, M.E. (1986). Influence of psychological factors on postoperative pain, mood and analgesic requirements. Pain, 24, 331342Google Scholar
Weis, O., Sriwatanakul, K., Alloza, J., Weintraub, M., & Lasagna, L. (1983). Attitudes of patients, housestaff and nurses toward post-operative analgesic care. Anesthesia and Analgesia, 62, 7074Google Scholar
Woodrow, K.M., Friedman, G.D., Siegelaub, A.B., & Collen, M.F. (1972). Pain tolerance: Differences according to age, sex and race. Psychosomatic Medicine, 34, 548556Google Scholar